Section 1 - Major Assistive Technology Funding Sources

Centers for Independent Living

There are five Centers for Independent Living in West Virginia. West Virginia Centers for Independent Living (CILS) provide services at no cost to persons of all ages who have physical, mental or sensory disabilities. The goal of this program is to give support to people with disabilities to help them become independent in their homes and other non-work settings. (See Appendix F for a complete listing of Centers.)

The Ron Yost Personal Assistance Services Program

In 1999, the West Virginia Legislature passed the Ron Yost Personal Assistance Services Act (RYPAS), which created a new consumer controlled program to help individuals with severe disabilities live in their own homes and be active in their communities. The RYPAS program provides individuals with severe disabilities the needed resources to help them hire a personal assistant to help perform essential daily living tasks.

You can get these Ron Yost services if you have a severe disability that affects one or more major life activities and:

Your disability will last at least 12 months

You or a designee can meet your responsibilities as an employer

You or a designee can manage your own financial and legal affairs

You need assistance with daily living activities

You are not receiving personal assistance through any Medicaid program

You meet income guidelines for adjusted annual income

For more information, call 304-766-4624.

WV Family and Community Support Program

The Program provides individual services and supports to families who have a member with a developmental disability living at home. Family Support provides information on and referrals to community services and supports, as well as, limited flex funds when all other support options have been exhausted. For more information, call (304) 356-4811 or visit http://www.dhhr.wv.gov/bhhf/Sections/programs/ProgramsPartnerships/IDD/Pages/default.aspx.

Medicaid

West Virginia's medical assistance program, Medicaid, pays for most of the cost of medical care for people who otherwise could not afford it. Medicaid is a state and federal assistance program that covers medical costs for eligible individuals of all ages. Medicaid is administered by the Bureau for Medical Services, West Virginia Department of Health and Human Resources (DHHR).

Eligibility for Medicaid is determined by local DHHR offices. There are over fifty different ways to become eligible for Medicaid. If you think you might be eligible for Medicaid, you may file an application at the DHHR office in the county where you live. Individuals receiving Supplemental Security Income (SSI) are also eligible for the Medicaid program and automatically receive a medical card from the Department of Health and Human Resources.

Medicaid covers augmentative communication devices. Coverage of these devices will be only for the purpose of assisting a person to communicate basic medical needs. Devices intended to meet social, educational and vocational needs are not covered.

For more information about Medicaid, call the Bureau for Medical Services at 304-558-1700.

Aged and Disabled Waiver Program

The Title XIX Medicaid Waiver Program provides in-home health care for eligible clients.

The West Virginia Bureau of Senior Services operates the Title XIX Medicaid Waiver Program, generally called the Aged and Disabled Waiver (A/D Waiver). This is a Medicaid reimbursed Home and Community Based Waiver program that functions as an alternative to institutionalized care. The A/D Waiver program covers those elderly, blind and/or disabled individuals who are eligible for Medicaid or would be eligible for Medicaid if institutionalized. To be eligible, applicants must:

Live in West Virginia and be aged 18 or older

Get approved by the WV Medical Institute, which assesses individuals to determine if they are medically eligible for nursing facility care

Require the level of care provided in a nursing facility as determined by comprehensive medical, nursing and social services assessments

Meet the Medicaid financial eligibility criteria for the program

Require services that do not exceed the statewide average cost of nursing home care

For more information on the Aged and Disabled Waiver, call 304-356-4913.

Intellectual/Developmental Disabilities Waiver Program

The Medicaid Title XIX Home and Community Based Services (HCBS) Intellectual/Developmental Disabilities (I/DD) Waiver program is designed to deliver services to individuals with intellectual or developmental disabilities in their homes or community. To be eligible, applicants must:

Have a diagnosis of intellectual disability (ID) and/or a related condition. The related condition must cause a person to function like someone who has ID

Have at least three substantial functional limitations

Require a level of care provided in an intermediate care facility for persons with intellectual iisabilities (ICF/ID), which provides care 24 hours a day seven days a week

For more information on the I/DD Waiver, call 304-356-4904.

Medicare

Medicare is a national health insurance program completely funded and run by the federal government. The Social Security Administration registers individuals and provides them with Medicare information.

Medicare helps pay health care costs for people 65 years of age or older, adults with permanent disabilities who receive Social Security Disability (SSDI) and people who have permanent kidney failure.

The Centers for Medicare & Medicaid Services, which runs the Medicare program, will mail Medicare cards to people with disabilities 24 months after their SSDI payments begin. Any person who qualifies for Medicare Part A will also be signed up for Part B. Part B has a monthly charge, but you may stop Part B if you do not choose to pay the monthly charge. Both parts A and B have deductibles, co-payments and co-insurance payments. Programs are available to help you pay Medicare premiums if you cannot afford them.

Part A - Hospital Insurance

Medicare Part A covers part of your stays in a hospital or in a skilled nursing facility, some home health care services and limited stays in hospice care. If you are admitted to a Medicare participating hospital, you should be given a copy of "An Important Message From Medicare." It explains your rights as a hospital patient. If you are not given one, ask for it.

Part B - Medical Insurance

Medicare Part B covers some medical care and outpatient costs, such as durable medical equipment and other medical services/supplies not covered under Part A if prescribed by your health care provider.

Medicare Premium Assistance Programs

Qualified Medicare Beneficiary (QMB)

This Medicaid coverage pays Medicare Part A and Part B premiums and Medicare co-pays and deductibles, including those related to nursing facility services. There is no prescription drug coverage.

Specified Low-Income Medicare Beneficiary (SLIMB)

Medicaid coverage is limited to payment of the Medicare Part B premium. The SLIMB applicant/recipient may be a recipient of other Medicaid coverage.

Qualified Individual (QI - 1)

Medicaid coverage is limited to payment of the Medicare Part B premium. The QI - 1 applicant/recipient cannot be a recipient of any other Medicaid coverage.

Assistive Technology Coverage

Assistive technology funding is addressed in Part B. Assistive technology falls under the categories of durable medical equipment (DME) and/or prosthetics, such as augmentative communication devices, if you lose your speech through a stroke or other condition.

Any decision about Medicare services can be appealed. This is true whether an individual is in the original Medicare Plan or a Medicare managed health plan. If Medicare does not pay for an item or service you have been given, or if you are not given an item or service you think you should get, you can appeal.

For more information, call the Social Security Administration at 800-MEDICARE (800-633-4227) or 877-486-2048 (TTY) or visit www.medicare.gov.

Private Insurance

Private insurance is a contract between you and your insurance company. Your contract may or may not cover assistive technology. Look over your policy carefully. Even when your insurance does cover assistive technology, your policy may have a cap on how much is covered.

If you receive private insurance from your employer there is a federal law known as the Employee Retirement Income Security Act (ERISA) that controls employee benefits plans. This law gives employees the chance to find out what the policy covers. Coverage guidelines will be written into a contract private insurance companies by law have to follow. Every insurance policy is different. Make sure you understand what your insurance policy covers.

You may not have health insurance through your employer but you can get insurance on your own. If you have questions about what your policy covers or would like to get insurance on your own, call the West Virginia Insurance Commission at 888-879-9842.

Rehabilitation Services, Division of

The West Virginia Division of Rehabilitation Services (DRS) is a state agency that helps people with disabilities obtain or maintain employment. The primary goal for all DRS clients is to become productive working citizens. A wide variety of services are offered to assist the individual in reaching their vocational goal. DRS is funded through the state and federal government. For more information on rehabilitation services or any of their programs (listed below), call 800-642-8207 or your local office. (See Appendix C for a list of offices).

Rehabilitation Technology Unit Services

The West Virginia Division of Rehabilitation Services Rehabilitation Technology Unit provides services to clients of the Division in the areas of rehabilitation engineering, assistive technology, driver rehabilitation, bioptic driving and environmental modification services to assist clients in reaching their rehabilitation goals. For DRS clients, Staff travel statewide to perform evaluations, equipment set up or installation, training in the use of adaptive equipment and follow up or technical assistance. Services can be provided at the worksite, school, home, in the local community or at the DRS facility in Institute, WV. Low, mid or high tech solutions can be identified to assist individuals in reaching independence in employment, through job placement, training, travel and functioning in the home. Non-DRS clients may obtain the following services on a fee-for-service basis: Bioptic Driving evaluations and training at the Nitro, WV location; Driver Rehabilitation evaluations, vehicle modification evaluations, and driving training at the Nitro, WV office- Oak Hill, WV office- and Morgantown, WV RTU office.

VISIONS is a statewide program funded by the federal government to provide in-home and community-based services to West Virginians aged 55 and older with a permanent visual impairment that impacts independent functioning in daily activities. The goal of VISIONS is to help these individuals achieve their desired level of personal independence.

Skills training including orientation & mobility, adaptive homemaking and activities of daily living training, community reintegration, selfadvocacy training, computer access technology training and much more

Referral to other agencies for talking book services, senior services, free directory assistance/operated calling and more

VISIONS conducts activities to improve public understanding of the concerns and problems faced by older adults with visual impairments by providing:

Outreach to community groups through presentations at workshops and meetings

Exhibits and demonstrations of low vision assistive technology at conferences and other events

To apply for services or receive additional information about the VISIONS program, call 800-642-3021.

West Virginia's Assistive Technology Revolving Loan Fund

The West Virginia Legislature set aside funds for a revolving loan fund to allow West Virginia residents with disabilities to purchase assistive technology. A seven-member board appointed by the Governor administers the fund. Loans may range from a minimum of $500 to a maximum of $5,000. A person may borrow up to 90 percent of the cost of the technology-related device or service. The interest rate is calculated at the time the loan application is received. For an application or more information, call 800-642-8207.

Social Security Programs

The Social Security Administration (SSA) administers the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs that can provide benefits based on the disability or blindness of individuals. The SSA can determine if an individual is eligible for one or both programs. For more information, call the SSA in your local area or call the toll free number 800-772-1213 or 800-325-0778 (TTY) or visit www.ssa.gov.

Supplemental Security Income (SSI)

SSI is a needs-based program that provides payments to individuals who are aged, blind and/or disabled and who have limited income and resources.

The amount of an SSI check can vary monthly due to earnings from work; unearned income (such as SSDI benefits; living arrangements and support that the individual may receive; the state the individual lives in; and any work incentives that may be used while that individual is working.

When you are approved for SSI, you will begin receiving payments because there is no waiting period.

You must report to Social Security any changes in your financial status, living arrangements or supports that you may be receiving. These factors could change the amount of SSI that you receive and/or your eligibility.

When you are approved for SSI in West Virginia, you also become eligible to receive a Medicaid card.

The SSA has developed work incentives that are available to individuals with disabilities who receive SSI and are thinking of going to work. It is important for disability beneficiaries to understand that they can still receive benefits while they test their ability to work. To learn more about the work incentives that are available, contact the Social Security Administration office at 800-772-1213 or 800-325-0778 (TTY) or the Ticket Call Center at 866-968-7842 or 866-833-2967(TTY)

Social Security Disability Insurance (SSDI)

SSDI provides benefits to individuals who are disabled or blind and are insured by the worker's contributions to the Social Security trust fund.To qualify you must be the worker, or the worker's widow(er), or the worker's adult child with a disability. You must also meet Social Security's definition of "disability." Unlike the SSI Program, this is not a needs-based program.

The amount of an SSDI check is based on the worker's lifetime average earnings covered by Social Security.

Usually there is a five month wait to receive SSDI cash payments but in some situations it may be sooner.

With SSDI a person will receive Medicare.

Work incentives are available to individuals with disabilities who receive SSDI and are thinking of going to work. The incentives provide the person with the opportunity to maintain benefits while testing their ability to work and gradually becoming self-supporting and independent. To learn more about the SSDI work incentives that are available you can contact the Social Security Administration office at 800-772-1213 or 800-325-0778 (TTY) or the Ticket Call Center at 866-968-7842 or 866-833-2967 (TTY).

U.S. Railroad Retirement Board (RRB)

The RRB provides benefits for railroad employees who are retired and have disabilities.

The RRB has special considerations for individuals who are recovering from a medical condition, have a permanent medical condition, are permanently disabled or have work expenses related to their disability.

The RRB help-line is an automated telephone service. You will not be able to speak to an RRB representative by calling the RRB help-line. Call the RRB field office if you want to speak to one of their representatives.

For more information call the RRB help-line at 877-772-5772, or visit secure.rrb.gov.

Veterans Affairs, Division of

Veterans Affairs (VA) provides health care for veterans and family members of veterans with disabilities.

Tricare

Tricare, formerly CHAMPUS, the health benefits program for dependents of active duty military service members and military retirees, will provide alternative/augmentative communication (AAC) devices to all program enrollees who require them. An augmentative communication device may be provided as a voice prosthesis under subsection 1077(a) (15).

For more information, call the local Veterans Affairs office in your area (see Appendix D) or the regional office at 800-827-1000.

Veterans Specially Adapted Housing Program

Adapted housing is part of the Department of Veterans Affairs (VA) program for the Paralyzed Veterans Administration. It provides qualified veterans financial help towards accessible housing. Veterans and family members of veterans who meet disability guidelines qualify for services. This program builds new homes, adapts existing homes and accommodates disability-related needs.

The special housing adaptation grant for veterans who are blind or who have lost or no longer have the use of both hands is $10,000. Veterans may also use the grant to assist in acquiring a residence already adapted with special accessibility features. The one-time adapted grant for veterans with disabilities including loss of one or both lower extremities is $50,000.

Veterans and service members with available loan guaranty entitlement may also get a guaranteed loan or a direct loan from the VA to supplement the grant to get a specially adapted home. Amounts with a guaranteed loan from a private lender will vary but the maximum direct loan from VA is $33,000.

If you have any questions regarding your eligibility for any of the above housing grant programs or need assistance with applying for them, call the local Veterans Affairs office in your area (see Appendix D) or the regional office at 800-827-1000.

Veterans Hearing-Aid Program

The Veterans Administration National Hearing Aid Program (VANHAP) evaluates hearing-aid technology with the National Institute of Standards and Technology and establishes national contracts for products of high technical quality. These hearing-aid devices are then available free to veterans in VA audiology clinics, which must meet criteria as hearing-aid dispensing programs. (See Appendix D for clinics).

Assistance with Adapting an Automobile to Meet Disability Needs

Veterans and service members with disabilities may be eligible for a one-time payment of no more than $11,000 toward the purchase of an automobile if they have service-connected loss or permanent loss of use of one or both hands or feet, permanent impairment of vision of both eyes to a certain degree, or immobility of one or both knees or hips. For more information, call your local Veterans Affairs office or contact the regional office at 800-827-1000.

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

"CHAMPVA for Life" is designed for spouses or dependents 65 or older. They must be family members of veterans who have permanent and total service-connected disabilities, who died of a service-connection or who were totally disabled from a service-connected condition at the time of death. They also must have Medicare coverage. For more information, call 800-827-1000 or visit www.va.gov/hac.

Combat-Related Special Compensation (CRSC)

CRSC was established to help military retirees who have service connected disabilities. Congress has authorized special compensation to help offset military retirement pay that is forfeited to receive disability compensation from the Department of Veterans Affairs. CRSC is only for those who have at least 20 years of military service and who have combat or operations-related disabilities. To find out more about this program and how and where to apply, call the Retiree Affairs office at the nearest military installation or go to the Department of Defense website at www.dfas.mil/retiredmilitary/disability/crsc.html

For more information on the above programs, call your local Veterans Affairs office (See Appendix D) or the regional office at 800-827-1000.